San Diego’s Six-Decade Dental Duel

Maybe fluoridation was a Communist plot. (Never mind that the City Council, not exactly the Politburo, had approved it unanimously a couple years earlier.) Or perhaps it was just the product of misguided scientists and public-health types who were inadvertently hurting people.

Whatever the case, city voters in the 1950s demanded the end of fluoridation. One part per million of fluoride, the mineral added to toothpaste, was a “dangerous experiment” on a “captive population,” as the ballot measure called Prop. A put it.

This week, San Diego finally reversed the decision that voters made during the Eisenhower administration. Fluoride is back in the water. Maybe this time for good.

Why did fluoridation take so long? It’s a tale of medical debate, legal battles and voters who just wouldn’t say yes.

It first became an issue in the late 1940s after communities began experimenting with adding fluoride to their water supplies. Scientists had earlier realized the value of fluoride by discovering that kids who got a lot of it due to its natural presence in their drinking water had low-levels of tooth decay. (Though, their teeth did get stained.) Tests showed that smaller amounts provided cavity-fighting powers without making teeth look bad, and many cities rushed to protect their kids.

“There was a lot of emphasis on kids and kids’ health, on providing a healthy generation of kids after the war,” said Catherine Carstairs, an associate professor at Canada’s University of Guelph who has studied the fluoride wars.

In 1952, the San Diego City Council joined other cities and voted to add fluoride to the city’s water supply. (Then, as now, some fluoride naturally appeared in the San Diego water supply.)

Not a single councilman objected.

But suspicions about the water were already in the air. Fluoride, after all, is a tricky substance: it can poison people. That’s why toothpaste tubes and fluoride rinses tell you to not swallow.

“Opposition movements start to raise a whole array of concerns about the long-term health effects and how maybe this isn’t the most cost-effective way to get fluoride into the hands of children,” Carstairs said. “A lot of elderly people would argue, ‘This is all very beneficial for children, but what effect will this have on our old bones?'”

And yes, some people linked fluoridation to the Cold War. “There were arguments that it would make the population docile and more rife for a Communist takeover,” Carstairs said of fluoridation. “But in general, that wasn’t the mainstream of the anti-fluoride movement.”

In San Diego, the anti-fluoride movement of the 1950s found an advocate in a man named C. Leon de Aryan, a two-time mayoral candidate who published a local Christian newspaper called The Broom that agitated against Jews, ethnic minorities and the establishment. He sued to stop San Diego’s fluoridation and kept appealing his losses all the way up to the California Supreme Court, where he lost again.

Then voters took care of the matter for him. In 1954, Prop. A passed by 53-47 percent and halted fluoridation of the San Diego’s water.

Fluoridation returned to the ballot in 1969, and voters again turned it down.

San Diego has been the largest city in the country without fluoridated water. Currently, all but a handful of the nation’s 50 largest cities now have fluoridated water.

Fluoride battles continued to rage into the 1990s and 2000s as people on both the left — including consumer advocate Ralph Nader — and the right found common ground by opposing fluoridation.

San Diego city officials tried to follow a mandatory state fluoridation law in the 1990s, but the 1954 vote stood in their way, at least for a while. Then a group called Citizens for Safe Drinking Water went to court to stop fluoridation when it appeared that the city could legally move forward with its plans.

“San Diego’s march toward fluoridation has continued to be beset by legal, political, technical and economic problems,” wrote the authors of the book “The Fluoride Wars: How a Modest Public Health Measure Became America’s Longest-Running Political Melodrama” in 2009.

San Diego finally began phasing in fluoridation this week. According to The San Diego Union-Tribune, the city is using grant money from a state fund to pay for expenses. The U-T found that the fluoridation process was delayed for several weeks after an engineer raised concerns about safety for water workers.

The city’s move comes as fluoridation is making the news across North America: The federal government has recommended a lower level of fluoride in water systems in order to prevent streaking and discoloration of teeth, which are thought to affect 40 percent of adolescents, although their effects usually aren’t serious.

“Especially over the past 10 years or so, it’s gotten more complicated,” she said. “There’s much more active debate among dentists whether fluoridation is appropriate. I don’t mean to say dentists are massively divided, but there is a greater influence of a few key voices who have greater respectability.”

Other factors have influenced the debate, she said, including a sharp decline in tooth decay in both fluoridated and unfluoridated communities.